Healthcare Provider Details

I. General information

NPI: 1497055537
Provider Name (Legal Business Name): LOVING HANDS ADULT DAY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2010
Last Update Date: 10/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 E BOULEVARD
KOKOMO IN
46902-2271
US

IV. Provider business mailing address

614 E POPLAR
KOKOMO IN
46902-2271
US

V. Phone/Fax

Practice location:
  • Phone: 765-455-2300
  • Fax: 765-455-4035
Mailing address:
  • Phone: 765-455-2300
  • Fax: 765-455-4035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CHARLESZETTA LEWIS LEWIS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 765-455-2300